Sex differences in prodromal symptoms in acute coronary syndrome in patients aged 55 years or younger

医学 急性冠脉综合征 心肌梗塞 焦虑 胸痛 前瞻性队列研究 儿科 疾病 队列 队列研究 年轻人 内科学 物理疗法 精神科
作者
Nadia Khan,Stella S. Daskalopoulou,Igor Karp,Mark J. Eisenberg,Roxanne Pelletier,Meytal Avgil Tsadok,Kaberi Dasgupta,Colleen M. Norris,Louise Pilote
出处
期刊:Heart [BMJ]
卷期号:103 (11): 863-869 被引量:57
标识
DOI:10.1136/heartjnl-2016-309945
摘要

Background

Studies suggest that young women are at highest risk for failing to recognise early symptoms of acute coronary syndrome (ACS).

Objectives

To examine sex differences in prodromal symptoms occurring days and weeks prior to the acute presentation of ACS. We also examined health-seeking behaviours and prehospital management in young patients.

Methods

Prospective cross-sectional analysis of 1145 patients (368 women) hospitalised for ACS, aged ≤55 years, from the GENdEr and Sex DetermInantS of Cardiovascular Disease: From Bench to Beyond Premature Acute Coronary SYndrome cohort study (January 2009–April 2013). Prodromal symptoms were determined using the McSweeney Acute and Prodromal Myocardial Infarction Symptom questionnaire. Health-seeking behaviour and prehospital care were determined by questionnaires.

Results

The median age was 49 years. The prevalence of prodromal symptoms was high and more women reported symptoms than men (85% vs 72%, p<0.0001). Symptoms were similar between sexes and included unusual fatigue, sleep disturbances, anxiety and arm weakness/discomfort. Chest pain was less common in both sexes (24%). Women were more likely to seek care (49% vs 42%, p=0.04). Among those who sought care, women were more likely to use an ambulance for their ACS compared with men (52% vs 39%). Cardiovascular risk-reduction therapy use was low (≤40%) in all patients and less than half perceived their care provider suspected a cardiac source.

Conclusions

Prior to ACS, women were more likely to experience prodromal symptoms and seek medical attention than men. Prehospital care was generally similar between sexes but demonstrated underutilisation of risk-reduction therapies in at-risk young adults.
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